Caboolture

This trial investigates whether fluid therapy with Plasma-Lyte48 increases the number of days alive and out of hospital by day 28 compared to 0.9% sodium chloride saline in critically ill patients with moderate to severe diabetic ketoacidosis DKA admitted to emergency departments and critical care units. DKA is a serious complication of diabetes, and hospital admissions for this condition have risen notably in recent years. Current treatment guidelines rely on limited evidence, creating a need for clearer information on the best fluid therapy approach. Participants receive either Plasma-Lyte48 or 0.9% saline as intravenous fluids for resuscitation during two 12-month periods across 20 hospitals, with a one-month break between periods. Each hospital switches fluids after the first period. The fluids are blinded and provided by Baxter Healthcare, with treatments continuing until discharge from critical care or up to 72 hours. Additional therapies, including glucose solutions and electrolyte supplements, are used as needed based on clinical judgment. During the study, patients are monitored for hospital-free days up to 28 days after enrollment, with telephone follow-up to collect information. Secondary outcomes include ICU-free days, readmissions, kidney function, mental status changes, ketosis resolution time, insulin use, and potassium replacement. The study involves consumer representatives and aims to provide evidence to improve DKA management. Total participation involves treatment and follow-up over 28 days post-enrollment.

Researchers are evaluating treatments for community-acquired pneumonia CAP, especially in patients admitted to intensive care units ICUs. This trial also adapts to study treatments for respiratory pandemics like COVID-19. The goal is to determine which treatment strategies improve outcomes for patients with severe pneumonia, using a flexible, ongoing approach that can test multiple therapies simultaneously and update as new information becomes available. Participants receive different treatment strategies based on random assignment to study groups. Treatments include various antibiotics, steroids, antivirals, immune modulators, anticoagulation methods, and ventilation strategies. Some treatment options have been closed to recruitment, reflecting the trials adaptive nature. The trial includes several domains targeting specific infections such as influenza and COVID-19, with dosing and duration guided by clinical practice and local guidelines. During the study, participants are monitored closely with assessments including survival up to 90 days, days alive without organ support in ICU, ICU and hospital length of stay, ventilator-free days, organ failure-free days, and quality of life up to 6 months. Researchers collect detailed data on patient outcomes, organ support needs, and hospital discharge status. The study runs until February 2028, with ongoing evaluation to improve pneumonia treatment strategies in ICU settings and during respiratory pandemics.

Researchers are evaluating the PIVO Pro needle-free blood collection device to reduce contamination in blood culture samples for patients suspected of bloodstream infection. This trial focuses on patients aged 18 and older who need blood culture tests in emergency departments. The goal is to compare contamination rates between the PIVO Pro device and the usual blood sampling methods, addressing issues like contamination and insufficient blood volume that affect test accuracy. Participants will be randomly assigned to either the PIVO Pro group or the control group using standard blood draw methods. The PIVO Pro device collects blood through a peripheral intravenous catheter by advancing a flexible tube beyond the catheter tip, aiming to obtain cleaner samples with less contamination. The control group will have blood drawn by usual methods like venepuncture or direct catheter draw. The trial includes an additional sub-study at one site examining catheter-related complications following blood draws. During the study, participants will receive standard care with no extra procedures required. Researchers will collect data on blood culture results, contamination rates, blood sample volume, and antibiotic use from medical records. Outcomes such as blood culture success without contamination and overall sample quality will be measured. The study will monitor participants for up to one week after blood collection to assess antibiotic use and catheter complications, ensuring safety and thorough evaluation over the trial period.